In HIV, CV Risk is Higher in Men

Subclinical coronary plaque and high-risk morphology plaque is less prevalent and burdensome among antiretroviral (ART)-treated women with human immunodeficiency syndrome (HIV) vs ART-treated men with HIV, according to a new study.

For their study, the researchers evaluated 48 women and 97 men with HIV with no known cardiovascular disease (CVD) who received ART.
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Subclinical coronary atherosclerotic plaque characteristics were compared between sexes. Previously completed computed tomography angiography and metabolic/immune phenotyping were also examined.

Findings indicated that the prevalence of any subclinical coronary atherosclerotic plaque was lower in women vs men with HIV (35% vs 62%), as was the number of segments with plaque.

Notably, the researchers also found that the prevalence of high-risk positively remodeled plaque (25% vs 51%) and the number of positively remodeled plaque segments were lower in ART-treated women with HIV vs men.

The association between male sex and coronary plaque (odds ratio [OR 3.8) and positively remodeled plaque (OR 3.7) remained significant following adjustment.

“ART-treated HIV-infected women (vs HIV-infected men) had a lower prevalence and burden of subclinical coronary plaque and high-risk morphology plaque,” the researchers concluded. “Thus, unique sex-specific mechanisms beyond subclinical plaque may drive the higher HIV-attributable risk of MI among women vs. men.”

—Christina Vogt

Reference:

Foldyna B, Fourman LT, Lu MT, et al. Sex differences in subclinical coronary atherosclerotic plaque among individuals with HIV on antiretroviral therapy [Published online March 27, 2018]. JAIDS. doi:10.1097/QAI.0000000000001686.